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Doing Telemedicine While Traveling

I earned $422 today doing telemedicine. I kept track of my income for the day so that I could give you guys a glimpse into what it’s like doing telemedicine while traveling. For those who don’t know, I’m a US physician living in Seville, Spain.

You can download my tutorial for doing telemedicine while abroad here.

 

Telemedicine While Traveling

I’m not a big sightseer but I do like going for walks and getting lost. The rest of the time I like to go bouldering at a gym, hanging out at a library, lounging at cafe’s, and cooking.

Today I woke up late because I was out until 2:00 am with new friends having beers and tapas. I didn’t see any patients online when I woke up so I turned off my phone and laptop and listened to some music while doing some exercises.

I made my coffee, avocado toast, then showered and was out of the house by around 11:00 am to head to a nearby library, the only one not closed for summer.

By the time I sat down, noon, I had a couple of telemedicine requests and knocked out 6 in the first hour while working on some blog posts and reading some emails.

I hit my $100/day target with those 6 patients and normally would have stopped but I decided to milk it a little more to write this post.

In the next hour I did another 5 patients and then 4 more throughout the rest of the day. The last 4 happened from 5:00 pm until midnight. It’s midnight now, in fact. I’m not tired yet so I thought I’d bust out this post.

 

Telemedicine Laws

Most telemedicine companies have told me that it’s against “HIPAA” for me to reside outside of the US and see patients. I haven’t found any such law – my lawyer doesn’t know of any such law. And the contract I signed with these telemedicine companies mentions no such rule.

Regardless, it’s their company and their lawyers have advised them on this rule. Fair enough.

There are other telemedicine companies which are fine with you doing telemedicine while residing outside of the US. So if you’re interested in doing telemedicine while traveling, seek those out. I’d love to mention their names but they have asked me to not mention their names on this blog.

I just got a LinkedIn message from a recruiter who was looking for an Oregon physician to do telemedicine for a new company. I told her I would be happy to if I can do it for Spain. She checked with the company and said it was all good.

 

Telemedicine Logistics While Traveling

Some of my telemedicine patients require a phone call or a video visit. However, with most I can communicate with via text.

I prefer the latter not only because it’s asynchronous but also because I can do it from a cafe, a library, a park, a bus, train, plane, or from the shitter.

Security

Just because a telemedicine company allows me to do telemedicine overseas doesn’t mean I will take it lightly. Security is my utmost priority. Both internet security and patient data security. If I fuck it up then I’ll ruin for myself and other traveling doctors in the future.

I use a VPN everywhere I go. I don’t even use public WiFi and tether to my own cell phone. This gives me a lot of control. It has the added benefit of showing my call and log-on location as the US.

I don’t do this to be deceitful but nobody, not even my own mamma has the right to know where I’m at in the world as long as I’m not breaking any laws. I prefer to protect my anonymity… which is why I share everything on a blog…? Okay, moving on.

Timing

“But I don’t want to ruin my vacation with telemedicine”. This is what one physician emailed me the other day after reading one of my telemedicine posts.

I’m not vacationing in Spain, I’m living here. I carve out some time to take care of responsibilities and some time for leisure.

Even though I’m financially independent and don’t need the income, I like having the income. I enjoy the work when I do only a little of it. And I’m still insecure about dipping into my investments.

My telemedicine work keeps me supplied with fresh Benjamins and I get to interact with interesting people. It has also led to some consulting work and has provided writing fuel for the UCC blog.

I can earn my $100 in less than hour. I have done a total of 1.5 hours of work today and earned $422. You can break this time up depending on how busy a particular telemedicine website is.

When It’s Raining Patients

Alternatively, if you set aside a time to do telemedicine and it doesn’t pan out, don’t sweat it and go enjoy your day. There is always tomorrow.

That’s the approach I’ve been taking. However, that means that if the following day I sit down to do telemedicine and it’s raining patients then I keep going for longer than planned.

The idea for me is to average a healthy income every week. I aim for around $800/week. If I can hit that in 2 days then I’m done for the week. It doesn’t mean that I won’t do more but I don’t actively try.

Sometimes a telemedicine representative will text or email me and even offer an incentive pay because they are slammed. Even if I’ve met my quota, as long as I’m in the mood, I’m happy to help.

Don’t Force It

Sometimes technology and the universe just don’t want to cooperate with you. My phone call connection is having a seizure. I can’t get the VPN to connect. Every patient I click on gets snagged up by some other doc.

Unless you need the money right then and right there, why force it? There will be another day. Have no fear, the telemedicine well will not run dry anytime soon.

Combine Activities

My gym is a 53-minute walk away. That’s 2 hours of downtime that I can spend doing telemedicine. I have my phone on me while listening to podcasts or music. When it ring I click on the patient and I bust out a telemedicine visit right there.

Sometimes I have a YouTube video or a movie playing and have my telemedicine app active on my phone. This style of multitasking works for me and it might work for you as well.

When I write a blog post I need to be semi-distracted. I get up, walk a little, take a sip of my water, take a leak, or respond to a telemedicine request. As I did just now. That’s another $17.

 

Breakdown of Today’s Work

I used 3 telemedicine platforms to do the work.

11 patients were from one company averaging about $15 per patient.

4 patients were from 2 other companies, averaging about $23/pt.

I did the first 6 patients at the library within about 30 minutes.

The next 5 were done once I got back home to make lunch over 50 minutes.

And the final 4 just popped up while I was exploring the town and walking to the gym.

 

Also consider reading:

Medical chart review experience – 3 month recap.

Earning a living doing telemedicine, good and the bad.

Juggling multiple telemedicine platforms. 

Income potential doing a full day of telemedicine; $2,798 in 1 day.

17 replies on “Doing Telemedicine While Traveling”

Welcome. It’s been a pleasant experience and there is a different feel to it than when you see patients in person. Patients do an impressive job of self-selecting to telemedicine and so there are rarely complicated cases. I’m really excited to see the niche practices popping up like birth control, ED, hair loss, weight loss, and of course the specialties like radiology, pathology, psychiatry, psychology.
Click on the telemedicine topic and there are a ton of posts on telemedicine and feel free to ask any questions.

How do you chart while walking to the gym? And how the the library telemedicine work? Do they have private offices/rooms?

2 of the companies I do telemed with don’t require separate charting. There might be private offices, I haven’t inquired. I just find a quiet place with nobody around and complete my phone call – if it’s a phone call. Sometimes it’s just messaging and it’s not hard to protect your screen for the sake of privacy.

great post!
are you aware of any similar opportunities for Indian doctors?

Are you referring to physicians who are licensed and live in India? I might have some suggestions. Please reach out to me over email and I can make some recommendations.

Dr Mo,

I love your blog! Thanks for sharing all this info about telemedicine!

I know that lots of physicians consider doing telemedicine from home, so I hope we’ll see more companies that let you work from abroad.

I’ve been a full-time locum tenens hospitalist but have strong family ties outside of the US and usually spend 2-3 months a year living abroad.

I’m thinking about doing telemedicine when I am out of the country but not sure where to start. Any advice? How much money can one realistically make with 5 state licenses – CA, FL, MI, PA, WA???

Thanks again!

With just three medical licenses from Washington and California and Oregon I am able to make about $2,500 a day if I work 10 to 12 hours with a company such as teladoc. There are other companies like Doctor on Demand and dial care and American well. It really depends on what kind of work you like to do since the number of telemedicine companies are only increasing.
You can look at options like Roman which is mostly for ED meds.
I’m not familiar with any telemedicine companies that allow you to work overseas. If you prefer not to disclose your location then of course there are ways to protect your privacy which will allow you to do telemedicine overseas. But this could also backfire if something bad happens and you have to answer to some legal powers.

I haven’t found a single telemedicine company which operates overnight. I suspect the volume will be much lower but perhaps the pay differential will offset that.

Would love to chat about your work and which companies you work for. I am living in Barcelona and have run up against the HIPPA argument.

Sure, you can reach me via email at drmo@digitalnomadphysician.com so we can figure out a time to connect. There should be lots of information on the various posts throughout the blog as well in regards to which companies are ideal to work for from overseas.
Look forward to connecting.

One aspect of telemedicine is that you don’t address the licensing laws of Spain. Spain considers you practicing medicine where you are physically located, regardless of where your patients are located. When we were in Ireland, the Board there said we were fine to contintie telemedicine while on holiday, but once we were residents we would need to be licensed in Ireland. There is the same issue in Spain and tin the EU.
The licensing board’s in Europe don’t give a hoot about what your company or state licensing boards say.

Let’s address the elephant in the room – you’re not allowed to work while you are on a holiday as a tourist in another country even if it’s your own patients back from the US. Once you get around that, there is the residency issue. You would still need a work permit even as a resident. Finally, if you are a resident with a work permit then you have to get permission for any self generate income which means licensing.

I don’t know much about international employment law and I can barely figure out the laws regarding my own medical board in my own state. But I am savvy with technology and have ways of protecting my privacy and transmitting data without anyone being able to prove exactly what I’ve been doing where and with whom. It’s not the right solution for everyone.

Telemedicine is becoming mainstream in Europe and getting your medical license on Spain isn’t all too hard as I outlined in my previous post so it might be an option to get licensed there for someone who wants to do everything on the up and up.

Hello,
I am a doctor in the USA and would like to live in lebanon for a year. Can you please let me know which telemed opportunities can be done while residing overseas? Do you have an email I can reach out to you to discuss more?

Thanks so much for this.

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